SURVEY QUESTIONNAIRE

To the Respondent:

The undersigned is currently conducting a research study entitled “Academic Stress and Depression
among Senior High School Students in The Fisher Valley College, Taguig City.
The purpose of this study is to investigate the relationship between academic stress and depression
among senior high school students in a private college in Taguig City.
Please accomplish this survey questionnaire by answering all questions as honest as possible.
Information gathered will be treated with utmost confidentiality and will be used for academic purposes only.
Thank you.

Sincerely yours,

Marlon B. Raquel
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PART I. PROFILE OF THE RESPONDENTS

1. What is your gender? ___ Male ___ Female

2. How old are you? ___ years old

3. What grade are you now? ___ Grade 11 ___ Grade 12

4. What is your strand? ___ GAS ___ ABM ___ STEM

PART II. EDUCATIONAL STRESS SCALE FOR ADOLESCENTS (ESSA) QUESTIONNAIRE

Directions: The following statements are about your feelings and attitude on your academic achievement and
study. Please choose the best answer and tick the proper number.

1 = Strongly Disagree 2 = Disagree 3 = Agree 4 = Strongly Agree

Educational Stress Scale for Adolescents (ESSA) Statements 1 2 3 4

1 I am very dissatisfied with my academic grades.
2 I feel that there is too much school work.
3 I feel there is too much homework.
4 Future education and employment bring me a lot of academic pressure.
5 My parents care about my academic grades too much, which brings me a lot of
pressure.
6 I feel a lot of pressure in my daily studying.
7 I feel that there are too many tests in the school.
8 Academic grade is very important to my future and even can determine my
whole life.
9 I feel that I have disappointed my parents when my test/exam results are poor.
10 I feel that I have disappointed my teacher when my test/exam results are not
ideal.
11 There is too much competition among classmates which brings me a lot of
academic pressure.
12 I am always lack of confidence with my academic scores.
13 It is very difficult to concentrate during classes.
14 I feel stressed when I do not live up to my own standards.
15 When I fail to live up to my own expectations, I feel I am not good enough.
16 I usually cannot sleep because of worry when I cannot meet the goals I set for
myself.
PART III. CENTER FOR EPIDEMIOLOGICAL STUDIES DEPRESSION (CESD) SCALE

Below is a list of the ways you might have felt or behaved. Please tell me how often you have felt this way
during the past week. Please choose the best answer and tick the proper number.

1 – Rarely or None of the Time (Less than 1 Day)

2 – Some or Little of the Time (1-2 Days)
3 – Occasionally or a Moderate Amount of Time (3-4 Days)
4 – Most or All of the Time (5-7 Days)

Center for Epidemiological Studies Depression (CESD) Scale Statements 1 2 3 4

1 I was bothered by things that usually don’t bother me.
2 I did not feel like eating; my appetite was poor.
3 I felt that I could not shake off the blues even with help from my family or friends.
4 I felt that I was just as good as other people.
5 I had trouble keeping my mind on what I was doing.
6 I felt depressed.
7 I felt that everything I did was an effort.
8 I felt hopeful about the future.
9 I thought my life had been a failure.
10 I felt fearful.
11 My sleep was restless.
12 I was happy.
13 I talked less than usual.
14 I felt lonely.
15 People were unfriendly.
16 I enjoyed life.
17 I had crying spells.
18 I felt sad.
19 I felt that people dislike me.
20 I could not get “going.”

What is the MOST DIFFICULT SUBJECT that you are taking this semester? __________________________

Thank you very much!